Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YM0800X | Mental Health Counselor | ||
Y | 104100000X | Social Worker |
NPI | 1003135021 |
---|---|
Provider Name | Sara Marshall |
First Address | Hyannis, MA 02601-1843 |
Second Address | Hyannis, MA 02601-1843 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2010 |
Last Update Date | 09/08/2013 |